Is it legal for a health insurance company to charge more for a procedure than what the actual charge from the hospital is?
Question Details: I recently had a procedure done. The actual cost from the hospital is around $2300 but the rate agreed upon between the hospital and insurance company is around $4800. Therefore the insurance company has paid the hospital around $2200 and I'm still responsible for the remaining amount. This doesn't seem right.
I am not clear how that occurred but a) speak with the payment office of the hospital and b) file a complaint with your state department of insurance. Re-review your bill and the statement from the insurance company. It may be the total is the $4800 but the piece insurance agreed to pay is $2200.
